From the St. Louis Regional Chamber & Growth Association (RCGA)
St. Louis Post-Dispatch -- April 9, 2009
by Gail Appleson

Early last month, William Cox was scheduled for a delicate catheterization procedure to treat an atrial flutter, a type of abnormal heart rhythm. Shortly before Cox, 72, was to be wheeled to the operating room, his doctor asked whether he would consent to a procedure using a magnetically steered, irrigated catheter that had just been approved by the FDA on Feb. 26.

The doctor explained the reduced risk and improved precision of the system that combines technology developed by St. Louis-based Stereotaxis Inc. and the catheter made by Biosense Webster, a Johnson & Johnson subsidiary.

"Frankly, I was thrilled they were going to use this new technology," said Cox, a Texas native who had the procedure at the Heart Hospital of Austin, Texas, one of the first U.S. hospitals to offer the new treatment. "I would have been able to go home the same day if it hadn't been for the sedatives. Absolutely, I was lucky to have the new catheter. Without any question at all."

On March 12, shortly after the Austin catheterization, Missouri Baptist Medical Center became the first St. Louis area hospital to use the device. Barnes Jewish Hospital is now also using the next-generation catheter. About 100 hospitals worldwide use the Stereotaxis Niobe system; so far, fewer than 50 percent of them have received the irrigated catheter through a phased rollout, said Mike Kaminski, Stereotaxis chief executive officer.

"The safety profile is incredible," he said. "It's really an important milestone for the company."

Irregular heart rhythms, called arrhythmias, can occur in a healthy heart and be of minimal consequence. They also may indicate a serious problem and lead to heart disease, stroke or sudden cardiac death.

While some arrhythmias can be treated with medication, others require a procedure known as ablation. This is when a catheter is used to emit high-frequency electrical energy and scar the tissue that's causing the irregular rhythm.

The ablation procedure using the Stereotaxis Niobe system allows doctors to use computers to guide a catheter through veins and inside the heart. In traditional catheterization, an electrophysiologist would manually push a small, stiff tube through the heart.

The Niobe system allows the doctor, operating from what looks like a cockpit equipped with computer screens, to gently pull a flexible catheter through the heart using magnets. The system reduces the risk of perforation and exposes the patient and medical staff to less radiation.

"We re-create the (heart) chamber on the screen," said Dr. J. Mauricio Sanchez, a specialist in cardiovascular disease and clinical cardiac electrophysiology, who is performing the procedures at Missouri Baptist. "It's a working model. It's kind of like GPS for the body. This catheter is soft and floppy, like a string of spaghetti. The only portion that is stiffer is the magnetically enabled tip."

The recently approved Navistar RMT Thermocool Catheter has a new type of tip that is cooled with fluid. Too much heat limits the amount of energy that can be delivered, Sanchez said.

Reprinted with permission of the St. Louis Post-Dispatch, Copyright 2009.